The purpose of this study was to measure the time to perform particular activities in the operating room and calculate the cost per minute to perform each activity. We timed how long it takes to perform 15 individual activities carried out by orthopedic trainees during total hip and knee arthroplasty. We developed an algorithm, and then measured the time taken for the preparation of 20 consecutive patients using it. With the algorithm, overall preparation time was reduced by 25.32% for each hip arthroplasty and by 27.60% (P < .0001) for each knee arthroplasty, saving £84.32 and £93.44 per case, respectively. Coordination between surgeons and theater staff is essential to reduce the time spent performing activities, and this will help improve theater efficiency.
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